Provider Demographics
NPI:1073017786
Name:AGUAYO, LAURA CHAIREZ (LVN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CHAIREZ
Last Name:AGUAYO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 NEWCASTLE PL
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-4930
Mailing Address - Country:US
Mailing Address - Phone:817-929-7987
Mailing Address - Fax:
Practice Address - Street 1:7009 NEWCASTLE PL
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4930
Practice Address - Country:US
Practice Address - Phone:817-929-7987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307747164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse